Precertification Specialist-1 Position Available In Charleston, South Carolina
Tallo's Job Summary: Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services. Determines which patient services have third party payer requirements and obtains necessary authorizations for care. Provides detailed communication to payers and clinical partners for compliance.
Job Description
Precertification Specialist-1
Charleston, South Carolina
Precertification Specialist-1
R-0000043990
Charleston, South Carolina
Patient Access, Records, Health Information, Medical Records & Coding
Business Operations
Full Time
Hospital Authority (MUHA)
Job Description Summary
Entity
Medical University Hospital Authority (MUHA)
Worker Type
Employee
Worker Sub-Type
Regular
Cost Center
CC002349
CHSCorp – Precertification Unit
Pay Rate Type
Hourly
Pay Grade
Health-20
Scheduled Weekly Hours
40
Work Shift
Job Description
Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services. This individual determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care, via phone, fax, or payer websites. The Specialist provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient’s record. Other duties as assigned.
Additional Job Description
Education:
High School Degree or Equivalent Work Experience:
1 year
